Surgical instrument



Nov. '29, 1927. 1,650,959

L. K. 'P lTMAN SURGICAL INSTRUMENT I Filed April 8. 1926 ATTORNEYPatented Nov. 29, 1927.

UNITED STATES LOUIS K. PITMAN, OF NEW YORK, N. Y.

SURGICAL INSTRUMENT.

Application filed April 8,

Heretofore, in treating affections of the. middle ear, it has been usualto puncture the ear drum in order to provide access to the middle ear.

It is the purpose of my invention to introduce and provide a means fortreating the middle ear and Eustachian tube without puncturing the eardrum or any other membrane. As is well known, the Eustachian tubeconnects directly with the nasal part of the pharynx. It is thereforepossible to reach the middle car by way of the nose and a catheter,bougie, filiform, etc. may beintroduced through the nose and manipulatedto enterthe Eustachian tube and the middle ear.

It is an object of my invention to provide a simple instrument forfacilitating and making certain treatments of this nature such as thecatheterization of the middle ear, dilation treatment of the Eustachiantube,

etc.

Other and further objects of my invention Will become apparent from thefollowing description, together with the drawings, of a preferredembodiment of my invention.

In the drawings:

Fig. 1 is a view in elevation of my instrument in condition for use.

Fig. 2 is a view in elevation of the guide taken at ninety degreestothat of Fig. 1.

The instrument that I have found most adapted for the purposes abovementioned consists, essentially, of a naso-pharyngoscope 1 and a guide2. The naso-pharyngoscope may be of a well known type and comprises atube 1, a mirror 3, a lamp 4, a sight opening 5 and terminals 6 for thelamp.

The guide 2 consists of a bent tube 7 having an ingress portion 8, astraight portion 10 and an exit portion 9, the portions 8 and 9, beingin planes parallel to each other.

Attached to portion 1O of the tube are means for mounting the guide ontube 1. In the preferred embodiment this consists of a cylinder 11 of asize adapted to fit over 1. It is obvious that this cylinder 11 may takethe form of one or more rings. In any event the mounting must be suchthat the guide may be moved along and around the tube 1. The ingressportion 8 is extended in order to form a handle which may be grasped bythe operator to turn or rotate 1926. Serial NO. 100,495. g

the cylinder 11 about the axis of the nasopharyngoscope 1. I

In operation the guide is placed on the tube 1 so that the egressportion 9 extends alongside the mirror. In this position it will easilyenter the limited opening provided by the nostril of the patient. Aflexible catheter of a well known type is passed through the guide sothat the free end projects. The instrument is then inserted up thenostril; the guide is given a slight turn to increase the visibility ofthe catheter; and the catheter and guide are then manipulated under theillumination afforded by the lamp until the free end enters theEustachian tube and reaches the middle ear. Medicaments may then beintroduced by way of the catheter. In the same manner, a bougie,filiform or similar instrument may be introduced to the Eustachiantubeor the middle ear.

The guide shown in the drawings is suitable of course only for the rightnostril. Both middle ears, however may be reached from either nostril.Nevertheless, I have found it more convenient to provide one for eachnostril as the manipulation is considerably simplified thereby. Ofcourse, by omitting the curvature of the terminal portion 9, it ispracticable to provide a single guide adaptable for both nostrils. Theform I have shown is preferable as it takes full advantage of themirror. It is obvious that a flap or other similar means may be added toguide the free end of the catheter, etc., if desired, I have found,however, that the simple form shown is sufiicient for all practicalpurposes.

I claim:

1. In combination a straight ex loring tube carrying illuminating meansan a mirror, an instrument guide comprising a tube having an end benttowards the mirror, and a sleeve secured to the guide and adapted to fitover the exploring tube.

2. In combination an exploring tube carrying illuminating means and amirror, an instrument guide comprising a tube having an end bent towardsthe mirror, and a sleeve secured to the guide and adapted to fit overthe exploring tube.

3. In combination an exploring tube carrying illuminating means and amirror, an

instrument guide comprising a tube having having a bent end, means formounting the guide upon the exploring tube With the bent end alongsideof the mirror in such manner as to permit rotating the guide about theexploring tube to position the bent end towards the mirror.

LOUIS K. PITMAN.

